Provider Demographics
NPI:1033124920
Name:JANNERS, SIGURDS (MD)
Entity Type:Individual
Prefix:
First Name:SIGURDS
Middle Name:
Last Name:JANNERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 W WATER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1949
Mailing Address - Country:US
Mailing Address - Phone:906-482-6705
Mailing Address - Fax:906-487-8053
Practice Address - Street 1:920 W WATER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1949
Practice Address - Country:US
Practice Address - Phone:906-482-6705
Practice Address - Fax:906-487-8053
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI030888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI112656951OtherPALMETTO GBA
MI1585458Medicaid
MI112656951OtherPALMETTO GBA
MI1585458Medicaid